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1.
Am J Orthod Dentofacial Orthop ; 158(2): 264-272, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32746976

RESUMO

INTRODUCTION: The anteroposterior position of the maxillary incisors has been studied since the beginning of cephalometric research. Most reports of ideal position have been based on measurements made on subjects with Class I occlusion without consideration of other facial variables. However, the ideal position is reflected in the soft tissues by the position of the lips. The purpose of this study was to consider the position of the maxillary incisor relative to other factors, including the thickness of the upper lip, and to evaluate its most aesthetic position using profile photographs. METHODS: The subjects in this study were 130 patients with Class I occlusion; their sex, age, thickness of the upper lip, and angular position of the maxillary incisor were recorded. From these 130 patients, 70 profile photographs that met the inclusion criteria were chosen for further evaluation. A survey was conducted among 60 lay people, 60 dentists, and 60 orthodontists. They were asked to classify the sets of photographs, from the most esthetic position of the upper lip to the least esthetic. RESULTS: For patients with thin lips, raters tended to prefer a more protruded position of the incisor than normal or between 8.0 mm and 11.5 mm in front of the Na-B bone and 4 mm in front of the Na-A bone. For patients with thick lips, the position of the incisor did not affect the perception of the profile. CONCLUSIONS: A correct skeletal scheme or Class I occlusion does not necessarily result in ideal facial harmony. Therefore, it will be necessary to consider all the factors that come into play, especially the lips, which are a key element in facial esthetics.


Assuntos
Incisivo , Lábio , Cefalometria , Estética Dentária , Humanos , Maxila
2.
Prog Orthod ; 21(1): 19, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32627109

RESUMO

The bilateral sagittal split osteotomy is considered the standard surgery to correct facial asymmetries. More recently, unilateral sagittal split osteotomy (USSO) was used to treat such malocclusions. AIM: To assess facial symmetry following USSO in the treatment of class III laterognathia. METHODS: Frontal facial photographs of four groups of patients were assessed: (1) pre-surgical group (n = 30) with skeletal asymmetry, (2) postsurgical group assessing patients of the first group 2 years after USSO, (3) control group (n = 30) of patients judged to have harmonious facial norms, and (4) mirrored group (n = 30) in which the control photographs were altered by duplicating the right half side of the face to replace the left half, thus creating perfectly symmetrical faces. All 120 photographs were distributed to 40 expert orthodontists to evaluate and score facial symmetry using the visual analog scale. Skin sensitivity and temporomandibular joint (TMJ) disorders were also assessed clinically pre and postsurgically. RESULTS: Statistically significant differences were observed between the pre-surgical group and each of the postsurgical and control groups (p < 0.001). The control and postsurgical groups received similar scores of symmetry (p = 0.774). The mirrored group received statistically significantly higher symmetry scores than either of the control or the postsurgical groups (p < 0.001). A reduction in TMJ disorders was noted after USSO and all patients reported normal skin sensation 2 years post-surgery. CONCLUSION: When indicated, USSO is a dependable and practical surgical approach to correct facial asymmetries associated with class III malocclusion.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Cefalometria , Assimetria Facial , Humanos , Mandíbula , Osteotomia Sagital do Ramo Mandibular
3.
J Clin Pediatr Dent ; 44(3): 202-208, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32644891

RESUMO

Objectives: The aim of study was to evaluate skeletodental and soft tissue treatment effects and the amount of maxillary molar distalization with modified C-palatal plates vs. Greenfield molar distalizer appliances in adolescents. Study design: The samples consisted of pre- and posttreatment lateral cephalograms collected from 39 patients with Class II malocclusion. The MCPP group was comprised of 21 patients (mean age: 11.7 ± 1.3 years) treated with MCPP appliances while the GMD group included 18 patients (mean age: 11.2 ± 0.9 years) treated with GMD. Fixed orthodontic treatment started with the distalization process in both groups. From each cephalograpm, twenty-nine variables were measured for analysis and then the two groups were compared. Descriptive statistics, a paired t-test, and multivariate analysis of variance were performed to compare the treatment effects within and between the groups. Results: There was significant treatmentrelated change in the sagittal position of the maxilla and the mandible within each group. However, there were no statistically significant inter-group differences. The mean maxillary first molar distalization was 3.96 mm in the MCPP group vs. 2.85 mm in the GMD group. Both groups showed minimal distal tipping, but the maxillary incisors were significantly extruded by 3.04 ± 0.89 mm (P < .001) in GMD group. There was no significant difference in treatment duration between the groups. Conclusions: The maxillary first molars of both the MCPP and GMD groups were effectively distalized and there were significant skeletal changes in the maxilla. However, the maxillary incisors were significantly extruded in the GMD group.


Assuntos
Má Oclusão de Angle Classe II , Procedimentos de Ancoragem Ortodôntica , Adolescente , Cefalometria , Criança , Humanos , Maxila , Dente Molar , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Técnicas de Movimentação Dentária
4.
Am J Orthod Dentofacial Orthop ; 158(2): 273-285, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32620481

RESUMO

A gummy smile is one of the most problematic characteristics in patients with a Class II Division 2 malocclusion, and the correction of vertical position and incisor torque is often challenging for the orthodontist. This case report describes the orthodontic treatment of a 31-year-old woman, assisted by miniscrew mechanics for maxillary arch distalization and correction of a gummy smile with a brachyfacial pattern. Two different mechanics were used. Miniscrews were placed in both maxillary tuberosities, and the maxillary arch was successfully distalized, correcting the Class II relationship. Interradicular miniscrews were placed for maxillary and mandibular incisor intrusion to correct the gummy smile, overbite, and torque. Finally, periodontal surgery was performed to lengthen the maxillary incisor crowns. Satisfactory smile esthetics and good occlusion were achieved. Follow-up after 24 months confirmed that the outcome was stable.


Assuntos
Má Oclusão de Angle Classe II , Adulto , Cefalometria , Estética Dentária , Feminino , Humanos , Incisivo , Maxila , Dente Molar , Procedimentos de Ancoragem Ortodôntica , Técnicas de Movimentação Dentária
5.
Stomatologiia (Mosk) ; 99(3): 60-70, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32608952

RESUMO

The aim of this research is to increase the accuracy of determining the position of the tongue, the amount of space occupied by the tongue and space, free from tongue, increase of efficiency of diagnostics of dentofacial anomalies in patients based on CBCT analysis-the study of the skull conducted in transversal, sagittal and coronal planes. Clinical and x-ray examination and orthodontic treatment were carried out in 120 patients with anomalies of the dentition complex. Patients were divided into three groups. Group 1 - 30 patients aged 5 to 11 years. Group 2 - 50 patients aged 12 to 17 years. Group 3 - 40 patients aged 18 to 40 years. All patients underwent CT examination of the skull before treatment, and during the retention period of treatment. After a diagnostic examination of the proposed method for diagnosing the anatomical and functional state of the dentition complex and drawing up a treatment plan, all patients underwent orthodontic treatment, which consisted in the expansion of the upper jaw using various orthodontic appliances for expansion. This method allows to identify anomalies in the position of the tongue before and after orthodontic treatment, to assess the quality of orthodontic treatment, based on the analysis of not only the tongue filling the space of the dome of the palate, but also the position of the bone structures of the skull in three planes. The high quality of the study allows us to give a reliable assessment of the state of maxillofacial structures: the position of the upper and lower jaws, inclination of teeth, the stage of formation of the patient's growth, airway lumen and the influence of tongue on these structures at different stages of development of the maxillofacial skull. When comparing the results of the study, not all patients carried out recovered the anatomical and functional balance of the maxillofacial complex after orthodontic treatment, suggesting the need for more myogymnastics of the tongue before, during, and after treatment.


Assuntos
Maxila , Técnica de Expansão Palatina , Adolescente , Adulto , Cefalometria , Criança , Pré-Escolar , Humanos , Palato , Língua , Adulto Jovem
7.
Shanghai Kou Qiang Yi Xue ; 29(1): 60-64, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32524123

RESUMO

PURPOSE: To investigate the profile self-perception of lower anterior facial height(LAFH) by patients seeking orthodontic treatment, and explore the influencial factors. METHODS: Profile photographs of two Chinese adults (one female and one male with normal profiles) were digitized to create two baseline templates. Changes in middle anterior facial height / lower anterior facial height ratio were made on the templates by altering lower anterior facial height from 0.5 to 1.5 in 0.1 increments. An electronic questionnaire survey was conducted among patients who met the sample criteria. They were asked to choose one from various photos that most resembled their own profile. Then profile photos of patients were taken and measured. Differences between self-perception profile and actual profile were compared using paired t test. Statistical analysis was employed for comparison between different age, genders, profile concerns, education backgrounds, orthodontic histories, marital status and facial types with SPSS 17.0 software package. RESULTS: Two hundred and twenty-six subjects (average age 19.2±6.0 years; 79 men, 147 women) were interviewed in this survey. The ratio of self-perception profile by the patients was lower than actual. Difference was significant between patients' actual profile and self-perception profile(P<0.01).Among the seven factors,profile concerns(P<0.01) and orthodontic history (P=0.002) were significantly correlated with profile self-perception of lower anterior facial height by the patients. CONCLUSIONS: There is a cognitive bias in profile self-perception of lower anterior facial height by patients seeking orthodontic treatment. The patients' self-perception of lower anterior facial height is influenced by profile concerns and orthodontic history, not by age, sex, education backgrounds, marital status and facial types.


Assuntos
Face/anatomia & histologia , Dente , Adolescente , Adulto , Cefalometria , Assistência Odontológica , Feminino , Humanos , Masculino , Autoimagem , Adulto Jovem
8.
Dental Press J Orthod ; 25(2): 25-31, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32490924

RESUMO

OBJECTIVE: Evaluate dental and skeletal changes resulting from the exclusive use of the cervical headgear for 15 ± 4 months in the treatment of patients with Class II division 1 malocclusion. METHODS: Differences between the beginning (T1) and immediately after the end of the therapy (T2) with the cervical headgear in growing patients (Experimental Group, EG, n = 23) were examined and compared, during compatible periods, with those presented by a group of untreated individuals (Control Group, CG, n =22) with similar malocclusions and chronological age. The cephalometric variables evaluated were: ANB, GoGn.SN, AO-BO, S'-ANS, S'-A, S'-B, S'-Pog and S'-U6 (maxillary first molar). The Shapiro-Wilk and Levene tests were used to evaluate the results. RESULTS: Significant differences were found relative to the ANB, S'-U6, AO-BO, S'-ANS, S'-A, S'-B and S'-Pog variables between T1 and T2 when comparing both groups. No statistically significant variation was found regarding the GoGn.SN angle. CONCLUSIONS: The use of cervical headgear promoted distal movement of the maxillary first molars and restricted the anterior displacement of the maxilla, without significantly affecting the GoGn.SN angle.


Assuntos
Má Oclusão de Angle Classe II , Cefalometria , Aparelhos de Tração Extrabucal , Humanos , Maxila , Dente Molar , Estudos Prospectivos
9.
Dental Press J Orthod ; 25(2)2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32490925

RESUMO

INTRODUCTION: Skeletal Class III malocclusion with asymmetry is one of the most difficult problems to correct in orthodontics. A functional shift of the mandible in growing patients may occur accompanying a Class III, due to constricted maxillary arch and occlusal interferences. Studies have indicated that posterior unilateral crossbite develops early and has a low rate of spontaneous correction. It may further lead to development of mandibular and facial asymmetry by growth and displacement of mandible if left untreated in growing patients. OBJECTIVE: This article reports the clinical case of a thirteen-year-old female patient in CVMI transition stage that had maxillary hypoplasia with a developing facial asymmetry. RESULTS: The case was successfully managed with bone-anchored facemask therapy and with elimination of occlusal interferences with guided occlusion. Reverse twin block in the retention phase maintained the results achieved. CONCLUSION: A four-year follow-up evaluation revealed successful maintenance of the treatment results.


Assuntos
Assimetria Facial , Má Oclusão de Angle Classe III , Adolescente , Cefalometria , Feminino , Seguimentos , Humanos , Mandíbula , Maxila
10.
Eur J Paediatr Dent ; 21(2): 123-128, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32567943

RESUMO

AIM: Interceptive treatment has been devised to improve the outcomes on growth stage and mandibular repositioning in Class II patients. The aim of this study is to test the effectiveness of Functional education (EF) (OrthoPlus, Igny, France) preformed appliance in skeletal Class II growing patients at CVM2 and CMV3 stages. MATERIALS AND METHODS: Study design: retrospective controlled study. Eighty skeletal Class II growing subjects were recruited for the study. Lateral X-rays and cephalograms were required at the beginning (T0) and at the end (T1) of the EF treatment to evaluate dento-skeletal changes. The same sub-division and sample size were adopted for respective untreated control groups. RESULTS: At prepubertal stage, the EF device showed a significant reduction of upper incisors proclination. When comparing dentoskeletal variables in the pubertal groups, significant differences were shown. In the treated group the SN^B angle increased, with the B Downs landmark moving forward. Wits index improved by 2.16 mm in the study group with an increase of all mandibular linear measurements. Fewer but significant dental changes were shown for 11^41 angle, with a mean increase of 8.90°. STATISTICS: For multiple comparisons, the Tukey test at 95% family-wise confidence level was used. The level of significance was set at p < 0.05. Statistical analyses were conducted using the R statistical package (version 3.0.3, R Core Team, Foundation for Statistical Computing, Vienna, Austria). CONCLUSIONS: EF appliance seems to be effective in the treatment of Class II growing patients. Significant improvements in upper incisors proclination and mandibular elongation are shown.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Cefalometria , Humanos , Mandíbula , Desenho de Aparelho Ortodôntico , Estudos Retrospectivos , Resultado do Tratamento
11.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(3): 301-307, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32573139

RESUMO

OBJECTIVE: This study aimed to investigate the therapeutic effects and advantages of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique. METHODS: Ninety-seven patients who received treatment for skeletal class Ⅲ malocclusion at the Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to January 2017 were selected for this retrospective study. All these patients refused surgery. They were divided into two groups in accordance with the type of skeletal malocclusion: mild-to-moderate skeletal malocclusion group (-4°≤ANB <0°) and severe skeletal malocclusion group (-8°≤ANB<-4°). Each of the two groups was divided further into two small groups in accordance with the technique used: T group (transmission straight wire technique) and M group (MBT technique). RESULTS: The crossbite of all 59 patients in the mild-to-moderate skeletal malocclusion group was successfully treated. The molars were classified as classⅠrelationship, and the facial profile improved. Significant differences were found in the values of U1/SN angle, L1/MP angle, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). In the severe skeletal malocclusion group, the crossbite of all 38 patients was cured or partially cured. Fourteen patients showed severe lower anterior teeth inclination (five in the T group and nine in the M group), and the profiles did not significantly improve. Significant differences were observed in the values of U1-NA value, U1/SN angle, L1-NB value, L1/MP angle, LLP, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). CONCLUSIONS: Relative to the MBT technique, the transmission straight wire technique has great advantages in improving facial profile, reducing the compensatory inclination of the upper and lower anterior teeth, and reducing the risk of root resorption in the treatment of skeletal class Ⅲ malocclusion.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão de Angle Classe II , Má Oclusão , Cefalometria , Humanos , Maxila , Estudos Retrospectivos
12.
Int J Comput Dent ; 23(2): 139-148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555767

RESUMO

Frontal cephalometric radiography (frontal ceph) is one of the important diagnostic methods in orthodontics and maxillofacial surgery. It allows one to determine occlusion anomalies in the transverse and vertical planes and to evaluate the symmetry of the facial skeleton relative to the median plane, including analysis of the position of the jawbone. AIM: The aim of this study was to develop an artificial neural network (ANN) for placing cephalometric points (CPs) on frontal cephs and to compare the accuracy of its performance against humans. MATERIALS AND METHODS: The study included 330 depersonalized frontal cephs: 300 cephs for training ANNs and 30 for research. Each image was imported into the ViSurgery software (Skolkovo, Russia) and the 45 CPs were arranged. The CPs were divided into three groups: 1) precise anatomical landmarks; 2) complex anatomical landmarks; and 3) indistinct anatomical landmarks. Two ANNs were used to improve the accuracy of CP placement. The first ANN solved the problem of multiclass image segmentation, and the second regression ANN was used to correct the predictions of the first ANN. The accuracy of CP placement was compared between the ANN and three groups of doctors: expert, regular, and inexperienced. Then, using the Wilcoxon t test, the hypothesis that an ANN makes fewer or as many errors as doctors in the three groups of points was tested. RESULTS: The deviation was estimated by the mean absolute error (MAE). The MAE for the points placed by the ANN, as compared with the control, was close to the average result for the regular doctor group: 2.87 mm (ANN) and 2.85 mm (regular group); 2.47 mm (expert group), and 3.61 mm (inexperienced group). The results for individual groups of points are presented. On average, the ANN places CPs no less accurately than the regular doctor group in each group of points. However, calculating all points in total, this hypothesis was rejected because the P value was 0.0056. A different result was observed among the inexperienced doctor group. Points from groups 2 and 3, as well as all points in total, were placed more accurately by the ANN (P = 0.9998, 0.2628, and 0.9982, respectively). The exception was group 1, where the points were more accurately placed by the inexperienced doctors (P = 0.0006). CONCLUSION: The results of the present study show that ANNs can achieve accuracy comparable to humans in placing CPs, and in some cases surpass the accuracy of inexperienced doctors (students, residents, graduate students).


Assuntos
Redes Neurais de Computação , Software , Cefalometria , Humanos
13.
Spec Care Dentist ; 40(4): 382-389, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32533731

RESUMO

The objective of this case report was to present the orthodontic treatment of an 8-year-old female patient with Fanconi's anemia and Class III skeletal pattern and agenesis of maxillary lateral incisors. Patient presented in the late mixed dentition with a Class III malocclusion with anterior and posterior crossbites. Rapid maxillary expansion and facemask therapy was performed for 12 months. Phase II was simplified with a 6 × 2 fixed appliance only in the mandibular arch for solving the anterior crowding. Maxillary canines were reshaped as lateral incisors and the central incisors were augmented for closing spaces. Although the systemic disease, orthodontic intervention is possible if individual limitations are considered and treatment is simplified.


Assuntos
Anemia de Fanconi , Má Oclusão de Angle Classe III , Má Oclusão , Cefalometria , Criança , Feminino , Humanos , Incisivo , Maxila , Técnica de Expansão Palatina
14.
Dental Press J Orthod ; 25(2): 44-51, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32490926

RESUMO

OBJECTIVE: To evaluate facial profile changes promoted by polymethyl methacrylate (PMMA) cement graft to reduce excessive gingival display due to hyperactivity of the elevator muscles of the upper lip during smiling. METHODS: Eleven patients (all females, age range: 20 to 43 years) presenting gingival smile that were treated with PMMA cement grafts in a private clinic were selected for this retrospective study. Three angular and ten linear cephalometric facial profile measurements were performed preoperatively (baseline, T1) and at least 6 months postoperatively (T2). Differences between T1 and T2 were verified by Wilcoxon test, and the correlation between the thickness of the graft and facial profile changes was statistically evaluated by Spearman's Coefficient test. The significance level was set at p< 0.05. RESULTS: The nasolabial angle (p= 0.03) and the labial component of the nasolabial angle showed statistically significant differences (p= 0.04), with higher values in T2. No correlations were found between the graft thickness and the statistically significant facial profile changes (p> 0.05). CONCLUSIONS: The PMMA bone cement graft projected the upper lip forward, thereby increasing the nasolabial angle without affecting the nasal component. No correlations between the graft thickness and the facial profile changes were detected.


Assuntos
Cimentos para Ossos , Sorriso , Adulto , Cefalometria , Feminino , Gengiva , Humanos , Lábio , Estudos Retrospectivos , Adulto Jovem
15.
Dental Press J Orthod ; 25(2): 69-85, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32490927

RESUMO

INTRODUCTION: Class II malocclusion, which has a significant incidence in the population, may compromise facial esthetics and the smile, as well as the masticatory and respiratory functions. Often associated with skeletal abnormalities, it severely affects and compromises quality of life. An accurate diagnosis is fundamental to prepare a treatment plan to correct dental and skeletal anomalies. OBJECTIVES: This study discusses treatment alternatives to the correction of Class II division 1 and 2 malocclusion in growing patients, using a Bionator and an extraoral appliance.


Assuntos
Má Oclusão de Angle Classe II , Má Oclusão , Aparelhos Ativadores , Cefalometria , Estética Dentária , Humanos , Qualidade de Vida
16.
Dental Press J Orthod ; 25(2): 32-43, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32490928

RESUMO

A healthy 15-year-old boy with anterior open bite, edge-to-edge transverse discrepancy, and Class III skeletal relationship sought a nonsurgical orthodontic treatment. The patient was treated with premolars extraction, a Hyrax expander and intrusion mechanics with vertical elastics. This mechanics allowed for excellent facial and occlusal results. The final occlusion presented Class I molar and canine relationships, ideal overjet and overbite, and straight facial profile. Analysis of the posttreatment and follow-up radiographs showed that the treatment outcomes remained stable seven years after active orthodontic treatment. Thus, although combined orthodontic and surgical treatment should be considered for patients with this skeletal malocclusion, this case report proves that well controlled orthodontic movement with the patient's cooperation can be a valid alternative treatment, with good and stable outcomes for patients who refuse surgery.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão de Angle Classe II , Mordida Aberta , Sobremordida , Adolescente , Cefalometria , Humanos , Masculino , Técnicas de Movimentação Dentária
17.
J Contemp Dent Pract ; 21(4): 438-444, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584283

RESUMO

AIM: The purpose of this cross-sectional study was to investigate the influence of maxillary posterior space discrepancy (MPDD) on angulation and vertical position of molars in patients with skeletal class II malocclusions, presenting long, short, and normal vertical growth patterns. MATERIALS AND METHODS: In total, 120 lateral cephalograms of patients (mean age: 23 years) with skeletal class II malocclusion were evaluated. Patients were divided into six groups based on their vertical growth pattern (normal, long, and short faces) and the presence or absence of maxillary posterior discrepancy. Maxillary molars' sagittal angulation and vertical position were measured on cephalograms via Dolphin™ three-dimensional (3D) software (version 11.5). The comparison between groups with the same vertical dimension and different status of MPDD was done with independent t test. The analysis of analysis (ANOVA) was used to make pairwise comparison between all six groups. Finally, a multiple regression analysis was performed to evaluate the influence of molar position and MPDD on the anterior overbite. RESULTS: The results showed that the angulation of the maxillary first molar was not statistically different between groups with the same vertical dimension but varied in terms of MPDD. The maxillary second molar was more distally inclined in patients with MPDD than those without MPDD with short and normal facial types (p value = 0.016 and p value = 0.001, respectively). The second molar had significantly more distal angulation in long face patients than short and normal face participants, without considering the status of MPDD. The upper first and second molars were erupted more in patients with long than short or normal faces, without any influence of MPDD. CONCLUSION: The presence of MPDD caused more distal inclination of the maxillary second molar, in skeletal class II patients with short and normal vertical growth patterns. CLINICAL SIGNIFICANCE: The status of MPDD and its effect on the maxillary second molar teeth should be considered in skeletal class II patients with short and normal vertical growth patterns.


Assuntos
Má Oclusão de Angle Classe II , Sobremordida , Adulto , Cefalometria , Estudos Transversais , Humanos , Mandíbula , Maxila , Dente Molar , Adulto Jovem
18.
J Orofac Orthop ; 81(4): 249-257, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32435863

RESUMO

PURPOSE: The aim of this study was to compare the mandibular posterior space in subjects with skeletal class II division 1 and division 2 malocclusions in two different age groups. METHODS: Pretreatment cephalometric radiographs of 160 patients from 9 to 13 years of age (n = 80) and 15 to 18 years of age (n = 80) with class II division 1 or division 2 malocclusion were used for the study. Equal numbers of male and female patients (n = 20) were included in the two age groups in each of the malocclusion groups. Eight linear and six angular measurements were taken for mandibular posterior space evaluation. The data obtained from the study were compared using the independent t-test. RESULTS: In the present study, the mandibular posterior space was greater in both malocclusion groups in subjects aged 15-18 years than in those aged 9-13 years (p < 0.05). The available posterior spaces behind the mandibular first molars were 4.4 mm and 6.3 mm in females (class II divisions 1 and 2, respectively) and 5.3 mm and 7 mm in males (class II divisions 1 and 2, respectively) in the 9­ to 13-year-old age group. This space increased significantly by 6.9 mm (p < 0.001) and 3.2 mm (p < 0.01) in females (class II division 1 and 2, respectively) and 3.8 mm (p < 0.01) and 3 mm (p < 0.01) in males (class II division 1 and 2, respectively) in the 15- to 18-year-old age group. CONCLUSION: Class II division 1 and division 2 malocclusions had similar and inadequate posterior space dimensions for the eruption of the third and an unknown portion of the second molars.


Assuntos
Má Oclusão de Angle Classe II , Má Oclusão , Adolescente , Cefalometria , Criança , Feminino , Humanos , Masculino , Mandíbula , Erupção Dentária
19.
J Orofac Orthop ; 81(4): 286-300, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32435862

RESUMO

INTRODUCTION: There is no consensus regarding which mode of activation or mandibular advancement (stepwise [SW] or maximum bite-jumping [BJ]) of fixed or removable functional appliances (FFA; RFA) for correction of Angle class II malocclusion is advantageous to produce dental, skeletal or condylar effects and has the lowest rate of undesired dental or technical side-effects. METHODS: A systematic search was conducted up to Oct. 20, 2019 in the MEDLINE, EMBASE, Scopus, Central Cochrane Library, and BBO databases. Included were preadolescent, adolescent, and adult humans with initial (pretreatment) Angle class II malocclusion, without further restriction. The intervention group was composed of subjects treated with FFA or RFA in SW mandibular advancement; the control group received BJ advancement. Search terms included prospective randomized and nonrandomized trials in English, German, Spanish, and Portuguese with the primary outcomes of skeletal and dental class II correction, effects on condylar growth, lower incisor proclination, overjet and overbite reduction. The risk of bias (ROB) was assessed using the Cochrane Collaboration's ROB2 tool. Mean differences were calculated and pooled by a meta-analysis using a random effects model. RESULTS: Data from five randomized controlled trials (RCT) with 401 participants (mean age 13.84 years; SD 1.53) were included; 331 derived from four studies were included in the meta-analysis. The ROB in the selected articles was high. We detected a slightly increased reduction of the ANB (mean difference [MD] -0.95°, 95% confidence interval [CI] -1.80 to -0.10°; I2 = 72%) that may be attributed to a slightly more pronounced increase of the SNB angle in SW-advanced mandibles (MD 0.27°; 95% CI -0.47 to 1.00°; I2 = 38%). SW advancement tended to reduce the undesired side effect of lower incisor proclination (MD = -1.59°; 95% CI -3.98 to 0.8°; I2 = 0%), indicating more pronounced mandibular incisor changes with bite-jumping advancement. CONCLUSION: There is weak evidence indicating a slightly increased reduction of the ANB and less lower incisor proclination with SW advancement compared to BJ, but the clinical relevance is debatable due to the small overall magnitude and small number of high-quality papers. REGISTRATION: Prospero #CRD42017075469 (www.crd.york.ac.uk/prospero).


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Sobremordida , Adolescente , Adulto , Cefalometria , Humanos , Mandíbula , Avanço Mandibular , Ortodontia Corretiva
20.
J Esthet Restor Dent ; 32(5): 496-504, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32462779

RESUMO

OBJECTIVE: A prime component in an esthetic and pleasing appearance of face is the proportionate presence of different compositions of the face. The present study aimed to evaluate the association between facial index, facial form, lip size, and angulation of anterior teeth with periodontal phenotype in males and females. MATERIALS AND METHODS: This cross-sectional study included 100 consecutive periodontally healthy orthodontic patients equally divided based on gender in two groups. The facial parameters including the Facial index (FI), lip size, and Gingival thickness (GT) for maxillary and mandibular incisors were measured using a digital vernier calliper. Maxillary and mandibular incisors inclination was measured using cephalometric analysis. RESULTS: Significant differences were observed among both the genders in terms of FI and facial forms, upper lip size, and angulations of mandibular anterior teeth and the periodontal phenotype. The GT was found to be strongly associated with the FI and mandibular anterior teeth angulation. CONCLUSION: The FI, and teeth inclinations are associated with the GT and shows sexual dimorphism. The evaluation of the periodontal phenotype and anthropometric parameters is essential during diagnosis and treatment planning for potential orthodontic patients and prediction of its influence on the periodontal tissues. CLINICAL SIGNIFICANCE: The gingival thickness varies with the facial index, facial form, teeth inclination, and lip size and thereby can be used to predict the pros and cons of orthodontic treatment and the need for prior periodontal therapy.


Assuntos
Gengiva , Lábio/anatomia & histologia , Cefalometria , Estudos Transversais , Face/anatomia & histologia , Feminino , Humanos , Incisivo , Masculino , Maxila
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